Systematic review and meta-analysis of prognostic microRNA biomarkers for survival outcome in nasopharyngeal carcinoma

Abstract

BackgroundNasopharyngeal cancer (NPC), despite being one of the most malignant head and neck carcinomas (HNC), lacks comprehensive prognostic biomarkers that predict patient survival. Therefore, this systematic review and meta-analysis is aimed to evaluate the potential prognostic value of miRNAs as prognostic biomarkers in NPC.MethodsPRISMA guidelines were used to conduct this systematic review and meta-analysis study. Permutations of multiple “search key-words” were used for the search strategy, which was limited to articles published between January 2012 and March 2018. The retrieved articles were meticulously searched with multi-level screening by two reviewers and confirmed by other reviewers. Meta-analysis was performed using Hazard Ratios (HR) and associated 95% Confidence Interval (CI) of survival obtained from previously published studies. Publication bias was assessed by Egger’s bias indicator test and funnel plot symmetry.ResultsA total of 5069 patients across 21 studies were considered eligible for inclusion in the systematic review, with 65 miRNAs being evaluated in the subsequent meta-analysis. Most articles included in this study originated from China and one study from North Africa. The forest plot was generated using cumulated survival data, resulting in a pooled HR value of 1.196 (95% CI: 0.893–1.601) indicating that the upregulated miRNAs increased the likelihood of death of NPC patients by 19%.ConclusionTo our knowledge, this is the first meta-analysis that examines the prognostic effectiveness of miRNAs as biomarkers in NPC patients. We noted that the combined effect estimate of HR across multiple studies indicated that increased miRNA expression in NPC potentially leads to poor overall survival. However, further large-scale prospective studies on the clinical significance of the miRNAs, with sizable cohorts are necessary in order to obtain conclusive results.

Prognostic and clinicopathological value of Ki-67 expression in patients with nasopharyngeal carcinoma: a meta-analysis

“…A variety of prognostic factors for NPC have been explored recently, including programmed cell death ligand-1, 34 EBV DNA levels, 35 microRNAs, 36 NLR, 9 and platelet-to-lymphocyte ratio. 37 These prognostic indicators showed significant prognostic value in NPC and are associated with the tumor microenvironment, immune responses, and EBV positivity.…”

Identification of two microRNA signatures in whole blood as novel biomarkers for diagnosis of nasopharyngeal carcinoma

“…With progress in high-throughput examination techniques for miRNAs, an increasing number of circulating miRNAs have been observed to be correlated with tumor diagnosis, progression, prognosis, and treatment response, demonstrating that these miRNAs have a large potential for diagnosis, prognosis, and treatment in patients with tumors [33, 48]. The circulating miRNAs with altered level have been proposed as promising biomarkers with several advantages, including stability in body fluid samples, non-invasive sampling, and easy and rapid manipulation.…”

The Prognostic Role of Programmed Death‐Ligand 1 in Nasopharyngeal Carcinoma

“…Furthermore, two recently published meta-analyses suggested the potential use of microRNA and long noncoding RNA. 25,26 Numerous studies have examined the utility of markers of systemic inflammation, including C-reactive protein, lymphocyte, neutrophil, platelet counts, neutrophil-tolymphocyte ratio, lymphocyte-to-monocyte ratio, and platelet-to-lymphocyte ratio. 27,28 Others have looked at the utility of radiographic parameters measured with positron emission tomography/computed tomography, such the maximal standard uptake value, metabolic tumor volume, and total lesion glycolysis.…”